The use of surgical cable and crimp assemblies to fix bone parts and to join them together until the bone heals is a well-known technique. Surgical procedures on and in the vicinity of a bone with closely neighboring nerves, arteries, muscle, ligaments, complicated anatomical structures, and delicate areas represent a difficult and time consuming task for the surgeon. Thus it is important for the cable and crimp device to be assembled accurately, minimizing stress, trauma, risk, and injury to a patient, and with little difficulty for a surgeon performing such procedures, in as rapid a timeframe as possible.
Furthermore it is desirable to maintain the bulk of the cable, as well as the joint where the cable is affixed to itself, as compact as possible to minimize discomfort to the patient and damage to the surrounding tissue.
The orthopedic procedure is as follows: the cable, isolated from the crimp member, is inserted to loop around the bone in a minimally invasive way. After the cable is looped around the bone, its beaded first end is inserted into the cavity of the first hole of the crimp member. The slot at the first hole of the crimp member allows the first end of the cable to slide in place until the bead locks in its final position. The second end of the cable is then inserted through the second hole of the crimp member. Then the cable is tensioned by application of a tensioning tool either directly to the cable or through a provisional crimp, to an abutment face of the crimp close to the second hole of the crimp member. Once the desired final tension is established, the crimp member is crimped into the cable, the tensioning tool is removed, and the free end of the cable at the abutment face of the crimp is cut off.
Different surgical tools have heretofore been known. However, none of the tools adequately satisfies these aforementioned needs. Most of the prior art surgical tools require pulling from both cable ends, after the cable is looped around the bone, as those disclosed in U.S. Pat. Nos. 5,649,927 and 6,017,347. These kinds of devices have the problem of requiring significant spreading of the incision and muscle trauma. As a result, they are not a good solution for work in restricted areas.
Other devices permit tensioning of the cable by application of a tensioning tool to one of the cable ends and to an abutment face of the crimp by using a surgical cable which is factory crimped to one of the holes of the crimp, as those disclosed in U.S. Pat. Nos. 5,423,820, 6,077,268 and 6,387,099. The same effect is achieved by instruments that use a wire with a beaded end, as that disclosed in one embodiment of U.S. Pat. No. 6,017,347. The bead locks into the end of the crimp preventing the wire from sliding out of the crimp.
The option of pulling the cable by application of a tensioning tool to only one of the cable ends and to an abutment face of the crimp provides marked improvement over pulling from both cable ends when working in a restricted area.
The effectiveness of the surgical cable and crimp assemblies has proven itself, but an improved surgical crimp is needed. The prior art instruments fail to provide an adequate technique and lengthen the overall procedure significantly. Thus there exists the need for an improved surgical crimp: compact, strong and easy to assemble in a confined area that allows the insertion of the surgical cable to loop the bone isolated from the crimp member, and to connect one of the cable ends to the crimp after the cable is looped around the bone.
For the foregoing deficiencies in the prior art, a new cable and crimp assembly is needed which permits insertion of a surgical cable and looping of the cable around a bone while the cable is isolated from the crimp member, and, only after the cable is looped around the bone, permits the connection of one of the cable ends to the crimp member.